Service Entry Permit

Third-Party Asset Access & Toolset Verification

Doc ID: TAG-OT-SEP-02
Compliance: IACS UR E27 §5
Rev: 1.0

1. SERVICE PARAMETERS

Technician:		Date:
Company:		System:	AMS NAV OTHER

2. TOOLSET & MEDIA VERIFICATION

Verify all external engineering tools before connection to any OT network.

Description (Laptop/USB/Tool)	Serial / Asset No.	AV Scanned?	Action
		Yes N/A	Allow Deny
		Yes N/A	Allow Deny
		Yes N/A	Allow Deny

3. ACCESS AUTHORIZATION

Network Access: Denied Service VLAN

Wireless Access: Not Allowed Temporary

Remote Access: Jump Server Direct

USB Use: Scanned Only Denied

Technician Declaration: I confirm that the engineering tools brought onboard have been scanned for malware within the last 24 hours. I will not install unauthorized software or hardware and will notify the ETO of any system configuration changes.

Technician Signature:

Full Name & Date

Authorizing Officer (ETO):

Rank, Signature & Date

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